Provider Demographics
NPI:1912730524
Name:ANHOLD, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ANHOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 PLAYGROUND RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6465
Mailing Address - Country:US
Mailing Address - Phone:843-573-2111
Mailing Address - Fax:
Practice Address - Street 1:1099 PLAYGROUND RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6465
Practice Address - Country:US
Practice Address - Phone:843-573-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician